Permit CITY OF TIGARD BUILDING PERMIT
2 COMMUNITY DEVELOPMENT Permit #: BUP2012 -00074
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/17/2012
Parcel: 1 S 134AA01800
Jurisdiction: Tigard
Site address: 10160 SW NIMBUS AVE F8
Project: Black Rabbit Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 2
Project Description: TI
Contractor: GUILD CONSTRUCTION INC Owner: HANSON, RONALD D
PO BOX 674 ROBINSON, CONSTANCE A
BEAVERTON, OR 97075 ROBINSON, CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK, WA 99331
PHONE: 503 - 957 -1173 PHONE:
FAX: 503 - 291 -1532
FEES
Specifics:
Description Date Amount
Type of Use: COM Permit Fee - Additions, Alterations, 04 /17/2012 $134.54
Class of Work: ALT Demolition
Dwelling Units: 0 12% State Surcharge - Building 04 /17/2012 $16.14
Stories: 1 Height: 0 ft Plan Review 04 /17/2012 $87.45
Bedrooms: 0 Bathrooms: 0 Plan Review - Fire Life Safety 04 /17/2012 $53.82
Value: $3,955 Info Process /Archiving - Sm $0.50 (up to 04/17/2012 $1.50
11x17)
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $293.45
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATT N: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
'`
Issu d By: J� aa, Perm J r h
ittee Signature: / �,K,
am
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
•
Building Permit Application
Commercial RECEIVED FOR OFFICE USE ONLY
City of Tigard Received • A� ., Oelo D'
aD 1 2012 DateB Permit No.:
° 13125 SW Hall Blvd., Tigard, OR 971etsR
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 = Q��j Other Permit:
Date/B
T 1 G A RD Inspection Line: 503.639.4175 C ITY OF'TIGARD Date Ready / y: Juris: El See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TY OF WOR REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Ni Indicate the value (rounded to the nearest dollar) of all
Addition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
El 1- and 2- family dwelling lat ommercial /industrial Valuation: $
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: /, , , ; I MINIM iaa New dwelling area: square feet
City /State /ZIP: sD vet , 11, q - 3 Garage /carport area: square feet
Suite/bldg. /apt. no.: Project name: _ *�;� .� r� �_. QQ,,� � Covered porch area: square feet
Cross street/directions to job site: /<-? Vh`� /!` iC 7 r Deck area: square feet
Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: I Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: ( )
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
Valuation: $
N Lou) Wet 1 IS � __ I f r
Existing building area: square feet
New building area: square feet
❑ PROPERTY OWNER I ,p ❑ TENANT � Number of stories: (-
Name: R00Ik /
50 Pi 1 11 Itptcc-lAtl(e, Id !., � f/6TWt4-me Type of construction:
Address: l0 7/ S WL K J i 4C.- 1.--.3 Occupancy groups:
S
City/State /ZIP: p -N 4 on„ 11-3 Existing:
Phone: (f03) se y -- f O v D Fax: (503 S I p- qq �f v z......-- New:
K APPLICANT ❑ CONTACT PERSON BUILDING PERMIT FEES*
Business name: (7 L i /4 1-14C.„....-- (Please refer to fee schedule)
�ll Structural plan review fee (or deposit):
Contact name: , GO lCO6'Cv
L FLS plan review fee (if applicable):
Address: Z. e X b-7 y
(1 tet V 6 /� / q ! —0 L 7 f' Total fees due upon application:
City/State/ZIP: f� v �'C q 70 ? � V `f
V q _I i� ( SA ) Z/ —/ Amount received:
Phone: J L J Fax:
E -mail: PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
_ roof -top mounted Photo Voltaic Solar Panel System.
Business name: 64, / / • �K c.,-- � Submit two (2) sets of roof plan with connection details
and fire department access, along with the 2010 Oregon
Address: ///��� e 6 Solar Installation Specialty Code checklist.
City /State/ZIP: &aid L lOyelm D fee (includes plan review
`(? 1 D 6 7 Pe and administrative fees): $180.00
Phone: (5 )') t? - f 1 Fax: (s�3 Zc( J— / , 3 -L.-- State surcharge (12% of permit fee): $21.60
o 1 1
CCB lic.: L ' Total fee due upon application: $201.60
Authorized signature: This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Date: Li.../ 6 �'�� * Fee methodology set by Tri -County Building Industry
Service Board.
1: \Building\Permits\BUP -COM PermitApp.doc 02/24/2011 440- 46I3T(I 1 /02 /COM/WEB)
1 Building Division
Over- The - Counter (OTC) Building Permit
TIGARD
Check List
Project Description: 17
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: .r Occupancy Group: •r Type of Construction: Na
*Type of Use: eCTI(/\ Occupancy Load: Oregon Specialty Code: 7_el►cD
SPECIFICS
Number of Stories: ,' Building Height: Mixed Use:
Number of Dw Units: Number of Bathrooms: Number of Bedrooms:
BUILDING SQ FT - SCHOOL CET OTHER SQUARE FOOTAGES
Story Square Footage: Accessory Structure: _ Covered Porch:
Basement: Garage: Deck:
Total Square Footage: Carport: Mezzanine:
SETBACKS
Sideyard Setback — Left Sideyard Setback — Front
Sideyard Setback — Right Sideyard Setback — Back
CONSTRUCTION
Exterior Walls: Openings Protected: Firewall Separation:
N: S: N: S: Occupancy Separation:
E: W: E: W: Access. Parking Spaces:
REQUIRED ITEMS
Fire Sprinklers: Fire Alarms: Smoke Detectors:
Parapet: Manual Pull Stations: Protected Corridors:
Total Project Valuation: $ Op ' Cr I FEES DUE
$ DC Prov Rvw, COM TI — Ping
$ DC Prov Rvw, COM TI — LRP
DC Provision Review Fee for COM TI $ Wi Permit Fee — Add, Alt, Demo
Project Valuation Planning LRP $ leln _ 12% State Surcharge
Up to $4,999 $0.00 $0.00 $ �1� Plan Review, Structural
$5,000 - $74,999 $64.00 $9.00 $ "T�j, Plan Review, Fire Life Safety
$75,000 - $149,999 $160.00 $24.00 $ Info Proc /Arch, Lg (over 11x17 $2.00)
$150,000 and over $256.00 $38.00 $ I , j ) Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Metro Construction Excise Tax
$ School Construction Excise Tax
$ Hourly Rate Fee
Planning Staff: $ Hourly Rate State Surcharge
$ Misc. Admin Fee
Permit Coordinator: $ Other:
$ Other:
Building Staff: $ Other:
Date /Time: $ - 2/33,TOTAL FEES DUE
�9
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
I: \Building \Forms \OTC - BUP.docx 01/13/2011
Building Division
TIGARD Accessibility: Barrier Removal Improvement Plan
REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241.
(1) Every project for renovation, alteration or modification to affected buildings and
related facilities shall be made to insure that the path of travel to the altered area and
the restroom, telephones and drinking fountains are readily accessible to individuals
with disabilities unless such alterations are disproportionate to the overall alterations
in terms of cost and scope.
(2) Alterations made to the path of travel to an altered area may be deemed
disproportionate to the overall alteration when the cost exceeds twenty -five per -cent
(25 %).
VALUATION: Total of all renovation, alteration or modification being 3 I $
done, excluding painting and wallpapering: [1] $
MULTIPLIER (25% barrier removal requirement): x .25
TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ 7s-()
ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be
given to those elements that will provide the greatest access. Elements shall be
provided in the following order:
(a) Parking $
(b) An accessible entrance: $
(c) An accessible route to the altered area: $
(d) At least one accessible restroom for each sex or a single unisex
restroom: $
(e) Accessible telephones: $
(f) Accessible drinking fountains: and, $
(g) When possible, additional accessible elements such as storage and
alarms: $
TOTAL (shall equal line [2] of Valuation Computation): $
I: \Building\Permits\BUP -COM PermitApp.doc 03/03/2011
Building Division
Development Code Provision Review
TIGARD Commercial Projects - No Associated Land Use Case
Building Permit rmit No: L ` a �� G t p
' E edited Review
x
Plari Submittal Date: I/1 % 7//
To the Applicant: /0/b i 'G�/ ////141/1 j 4A g
> If the proposed use is not permitted within the zone, please contact the Building Division to cancel
the permit application. Building Permit Technicians (503) 718 -2439.
> If a land use is required and for all other questions, please contact the staff person listed above the
Planning Review section.
Staff: please check items along left only if approved.
Planning Review (contact , at 5O3-718-4 or i@ tigard- or.gov)
Er Zoning C Permitted Use Yes L9 No ❑ •
'Land Use Required: Yes ❑ . No L> (explain below)
Notes: 4A / i � � / . ' , ,i , / er• . lAI /✓ � 1 i., .: � _
n Approved ❑ Not Approved Date: `'r / '
•
v
Permit Coordinator Review (contact Albert Shields at 503 - 718 -2426 or albert@tigard- or.gov)
•
Notes: /
1v
Routed back to Building Division Date:
I: \CURPLN